<!doctype html>
<html>
<head>
<meta charset="utf-8">
<title>确诊病患管理</title>
	
	<style>
		.shouye a{text-decoration: none;}
	body{background-color: #E8E7E3;}
	</style>
	</head>	


	
<body>

<div ><h1 class="shouye" align="left"><a href="shouye.html" >首页</a></h1>
   
    <div>

        <section class="content-header">
            <h1 align="center">
                确诊病患管理 
            </h1>
           
        </section>
    
        <form action="/patient/addBase"
              method="post">

            <section class="content">

                <div class="panel panel-default">
                    <div class="panel-heading"><strong>基本信息</strong></div>
                    <div class="row data-type">

                        <div class="col-md-2 title">姓名</div>
                        <div class="col-md-4 data">
                            <input type="text" class="form-control" name="name"
                                   placeholder="姓名" value="">
                        </div>
                        <div class="col-md-2 title">身份证号码</div>
                        <div class="col-md-4 data">
                            <input type="text" class="form-control" name="idCard"
                                   placeholder="身份证号码" onblur="IdentityCodeValid(this.value)" value="">
                        </div>
                        <input type="text" name="msg"
                               value="patient" hidden="">
                        <div class="col-md-2 title">年龄</div>
                        <div class="col-md-4 data">
                            <input type="text" class="form-control" name="age"
                                   placeholder="年龄" value="">
                        </div>


                        <div class="col-md-2 title">性别</div>
                        <div class="col-md-4 data">
                            <select class="form-control select2" style="width: 100%"
                                    name="gender">
                                <option value="男" selected="selected">男</option>
                                <option value="女">女</option>
                            </select>
                        </div>

                        <div class="col-md-2 title">地址</div>
                        <div class="col-md-4 data">
                            <input type="text" class="form-control" placeholder="地址"
                                   name="address" value="">
                        </div>
                        <div class="col-md-2 title">电话号码</div>
                        <div class="col-md-4 data">
                            <input type="text" class="form-control" placeholder="电话号码"
                                   name="phone" value="" onblur="validatemobile(this.value)">
                        </div>

                    </div>
                </div>
                
                <div class="box-tools text-center">
                    <button type="submit" class="btn bg-maroon"><a href="详细信息.html">下一步</a></button>
                    <button type="button" class="btn btn-bitbucket"><a href="系统用户管理.html">返回</a></button>
                </div>
               </section>
           
        </form>
    </div>
   



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</body>
</html>
